Hepatitis C

Overview

Hepatitis C is an infection caused by hepatitis C virus and causes inflammation of the liver and may sometimes lead to serious liver damage. The virus spreads through contaminated blood.

Most people with the HC virus do not know they have it because it causes few or no symptoms at all.

World Health Organization reports that an estimate of 71 million individuals has chronic hepatitis C infection with the majority of them developing cirrhosis or liver cancer. About 339,000 individuals die annually from hepatitis C, mostly from hepatocellular carcinoma and cirrhosis.

In Kenya, medical researchers from KEMRI and different universities in Kenya conducted a study to substantiate the prevalence of hepatitis A to E involved 389 patients with jaundice at 4 hospitals. They are Kenyatta National Hospital, Moi Teaching and Referral Hospital, Coast General Hospital, and New Nyanza Provincial General Hospital in Kisumu in 2017.

The findings indicate that 3.9% of the samples collected were positive for Hepatitis C. When the positives were confirmed, none of the participants indicated exposure to the virus which means that they did not have active infection.

Symptoms

The incubation period for HC infection is 2 weeks to 6 months. After the initial infection, about 80% of individuals do not exhibit any signs or symptoms. People who are acutely symptomatic may show the following symptoms:

  • Decreased appetite
  • Fever
  • Nausea
  • Fatigue
  • Abdominal pain
  • Grey-colored faeces
  • Vomiting
  • Dark urine
  • Joint pain
  • Jaundice
  • Itchy skin
  • Weight loss
  • Swelling legs
  • Spider-like blood vessels on the skin
  • Fluid buildup in the abdomen (ascites)

Causes

Hepatitis C infection is caused by hepatitis C virus. However, the virus spreads or is transmitted through the body fluids or blood of an infected person. You are likely to catch it from (RISK FACTORS):

  • Having unprotected sex with an infected person
  • Having sex if you have STD, several partners, an HIV infection, or rough sex
  • Being stuck by infected needles
  • Sharing personal care items such as razor blades, toothbrushes, and nail clippers
  • Getting a piercing or tattoo with unclean equipment   

The following are myths that CANNOT cause hepatitis C infection:

  • Coughing
  • Breastfeeding (unless nipples are bleeding or cracked)
  • Hugging
  • Holding hands
  • Sharing eating utensils
  • Kissing
  • Sneezing
  • Sharing food or drink
  • Casual contact

Complications

Hepatitis C infection that persists for many years can cause significant complications such as:

  • Liver cancer: A small number of individuals with HCV may develop liver cancer.
  • Scarring of the Liver (Cirrhosis): This may occur after two or three decades of hepatitis C infection.
  • Liver failure: Advanced cirrhosis may lead to a dysfunctional liver.

Diagnosis

 The doctor will ask you about your symptoms and whether or not they exist, he or she will proceed with the following tests:

  • Anti-HCV antibodies: These are proteins that the body produces when it finds HCV in your bloodstream. They normally appear after 20 weeks of infection. Once they exist, the doctor will suspect you have the virus and will proceed to the next test.
  • HCV RNA: This is the measure of the number of viral RNA particles in your bloodstream. They show up between 1 and 2 weeks of infection. As part of the diagnosis process, the doctor may also conduct the following.
  • Liver Function Tests: They measure enzyme and protein levels that normally increase 7 to 8 weeks of HCV infection.

Treatment

Unlike hepatitis A and B that have no treatment and depend on vaccination, hepatitis C does not have vaccination but has treatment.

There is no recommended treatment for acute hepatitis C other than lifestyle changes but if the condition turns into a chronic hepatitis C infection, the following medications are available:

  • Daclastasvir (Daklinza): It is a pill taken once every day alongside sofosbuvir for 12 weeks.
  • Sofosbuvir-velpatasvir (Epclusa): It is a daily pill taken for 12 weeks and cures the disease 99%.
  • Glecaprevir and pibrentasvir (Mavyret): It is also daily pills (3 tablets/day) taken for 8 weeks
  • Peginterferon (Pagasys): Taken as a shot under the skin once a week for 12 to 24 weeks
  • Ribavirin: It comes as a table, liquid, or capsule and is taken with food twice a day for 24 to 48 weeks.
  • Sofosbuvir (Sovaldi) with interferon and ribavirin: Taken at the same time once every day for 12-24 weeks.
  • Ombitasvir-paritaprevir (Technivie): Taken by mouth mostly alongside ribavirin.
  • Ombitasvir-paritaprevir-dasabuvir-ritonavir (Viekira Pack): It is a combo of pills; two taken once a day and one taken twice with meals for 12 to 24 weeks.
  • Vosevi: It is a combination of pills approved for treating adults with chronic HCV with or without cirrhosis.
  • Elbasvir-grazoprevir (Zepatier): Taken once daily and is very effective as it has cured 97% of those treated.

Note that most of these medications have side effects that range from mild to severe effects. They include hair loss, headache, depression, trouble thinking, low blood counts, nervousness, flu-like symptoms, and fatigue.

Make sure you use them under prescription and close monitoring by the doctor.

Prevention

  • Do not share syringes, needles, or other equipment when injecting drugs
  • Use condom every time you have sex
  • Be careful if you get a tattoo, manicure, or body piercing because the equipment used might have an infected person’s blood on it.
  • Do not share personal items such as razors

For more information on treatment, speak to a doctor, or get access to a hospital near you through the Uzima Health App.

Sources

https://theconversation.com/mapping-hepatitis-in-kenya-shows-where-action-is-needed-81768

https://www.who.int/news-room/fact-sheets/detail/hepatitis-c

https://www.webmd.com/hepatitis/digestive-diseases-hepatitis-c

https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278